Suicide is a leading cause of death in the United States and in many other parts of the world. As such, suicide is frequently framed as a medical and public health problem for which solutions are best recommended by medical and public health authorities. While, medicalized suicide prevention strategies often resonate with traditional Christian commitments to preserve life and to discourage suicide, there is little evidence to date that medical approaches to suicide risk-reduction decrease population rates of suicide. Further, by (...) treating suicide as a phenomenon that can be eliminated through technical managerial control, modern suicide prevention efforts construe suffering persons as carriers of risk best managed by standardized and often dehumanizing environments of care. This emphasis on the medical management of risk also erodes the clinician–patient relationship and inappropriately centers medical (e.g., systematic health screenings) rather than non-medical (e.g., access to housing) forms of response. Although, medicalized suicide prevention efforts should not be dismantled, those working to prevent suicide would do well to prioritize a positive commitment to human dignity and worth and to engage social and political systems beyond medicine and public health, while drawing on specific contributions that clinicians can offer. (shrink)

In this paper, I attend to a current strand in bioethics that forwards solidarity as a promising direction for bioethics theory and health-promoting practices. Drawing on resources from social and political philosophy, I argue that we can gain useful insight in bioethics if we understand solidarity as a political relation grounded not on shared social location but rather on shared visions for the sorts of worlds in which collective health and dignity proliferate. I consider what traction this conception of solidarity (...) might give for thinking about social justice issues in the context of political movements for “reproductive justice.”. (shrink)

Catholic end-of-life ethics does not contain a principle that prohibits the excessive use of medical treatment for declining and dying patients. This article fills this lacuna by exploring and developing the principle of unreasonable means. Unreasonable means are present when the burdens to the patient and community far outpace the benefits to the patient and when the use of such means directly or indirectly limits another patient’s access to ordinary means. Unreasonable means reinforce the redistribution of limited medical resources from (...) the poor to the wealthy and from the global south to the global north. The principle of unreasonable means guides individual patients and medical proxies to preferentially opt for the morally ordinary medical needs of others before the patient’s own extraordinary medical needs. The principle underscores the need for patients and proxies to incorporate justice and the common good into end-of-life decisions. (shrink)

It is foundational to ethics and bioethics that individuals will have to make hard decisions, frequently in challenging circumstances. But the scenarios and standard modes of theorizing in bioethics may fail to address important ethical questions, in part because of a paradigmatic focus on individual rights and freedoms in the context of decision making. There is a growing conviction that theorists of ethics and bioethics must reframe our core units of analysis to attend to health in public, collective, relational terms.1 (...) This would involve a move from an approach that focuses primarily on the relation between doctors and patients or between researchers and research subjects to something very different— something .. (shrink)